Tracking prespecified diet and weight-loss goals via a smartphone app may be an effective strategy for losing weight for adults with obesity, but different approaches to this plan may not substantially affect results, according to findings published in JMIR mHealth uHealth.

Michele L. Patel

“We have ‘gold standard’ lifestyle interventions for obesity, but they are often too costly and not scalable. Weight loss apps have been downloaded hundreds of millions of times, but surprisingly, we didn’t really know how well they worked,” Michele L. Patel, PhD, a postdoctoral fellow in cardiovascular disease prevention at the Stanford Prevention Research Center in Palo Alto, California, told Endocrine Today. “This is the first study to show that simple weight loss apps — widely available on app stores — can actually help people lose a healthful amount of weight.”

Patel and colleagues conducted a 3-month randomized controlled trial comparing three strategies for weight and diet monitoring using the MyFitnessPal smartphone app. The first was termed simultaneous and involved tracking weight and diet for the entire trial. The second strategy (sequential) required participants to track only weight for 1 month and then track weight and diet for the remainder of the trial. Lastly, the app-only strategy tracked only diet. Both the simultaneous and sequential groups also received feedback about weight and diet outcomes as well as skills training.

Participants were aged 21 to and 65 years with a BMI of at least 25 kg/m2 but not more than 45 kg/m2. The researchers recruited 105 participants (mean age, 42.7 years; 84% women; mean BMI, 31.9 kg/m2) from central North Carolina between April 2017 and September 2017 and randomly assigned each to follow one of the three tracking strategies with a goal of 5% weight loss. Weight was measured at baseline and at follow-up visits at 1 month and 3 months and self-reported at 6 months.

After 3 months, the researchers found that there was significant weight loss in all three groups, but that there was no significant difference between the levels achieved. This carried over for the proportion of participants who reached 3% weight loss, with readings of 44%, 41% and 29% in the sequential, simultaneous and app-only groups, respectively. In addition, 31% of participants in the simultaneous group reached 5% weight loss compared with 21% of the sequential group and 15% of the app-only group, with the researchers noting that these were not statistically significant differences.

The researchers also found little difference between the sequential and simultaneous groups in days with tracked weight and among all three groups after 1 month in diet tracking. However, there was an association between weight change and the percentage of days tracking weight in the simultaneous (P = .02) and sequential (P = .01) groups. Diet tracking was linked to weight change in the app-only group (P = .003) and the sequential group once it was adopted (P = .02), but not in the simultaneous group.

“There were two surprising outcomes. The first was that our ‘app only’ control group performed better than we expected. This suggests that even a minimal approach can help adults with overweight or obesity achieve weight loss of 2 kg to 3 kg (5 lbs to 6 lbs), on average, over a 3-month period, and sustain that weight loss through 6 months,” Patel said. “The second surprise, was that it didn’t seem to matter if you delayed diet tracking vs. if you got started with tracking your diet right away.” – by Phil Neuffer

Disclosures: The authors report no relevant financial disclosures.

Tracking prespecified diet and weight-loss goals via a smartphone app may be an effective strategy for losing weight for adults with obesity, but different approaches to this plan may not substantially affect results, according to findings published in JMIR mHealth uHealth.

Michele L. Patel

“We have ‘gold standard’ lifestyle interventions for obesity, but they are often too costly and not scalable. Weight loss apps have been downloaded hundreds of millions of times, but surprisingly, we didn’t really know how well they worked,” Michele L. Patel, PhD, a postdoctoral fellow in cardiovascular disease prevention at the Stanford Prevention Research Center in Palo Alto, California, told Endocrine Today. “This is the first study to show that simple weight loss apps — widely available on app stores — can actually help people lose a healthful amount of weight.”

Patel and colleagues conducted a 3-month randomized controlled trial comparing three strategies for weight and diet monitoring using the MyFitnessPal smartphone app. The first was termed simultaneous and involved tracking weight and diet for the entire trial. The second strategy (sequential) required participants to track only weight for 1 month and then track weight and diet for the remainder of the trial. Lastly, the app-only strategy tracked only diet. Both the simultaneous and sequential groups also received feedback about weight and diet outcomes as well as skills training.

Participants were aged 21 to and 65 years with a BMI of at least 25 kg/m2 but not more than 45 kg/m2. The researchers recruited 105 participants (mean age, 42.7 years; 84% women; mean BMI, 31.9 kg/m2) from central North Carolina between April 2017 and September 2017 and randomly assigned each to follow one of the three tracking strategies with a goal of 5% weight loss. Weight was measured at baseline and at follow-up visits at 1 month and 3 months and self-reported at 6 months.

After 3 months, the researchers found that there was significant weight loss in all three groups, but that there was no significant difference between the levels achieved. This carried over for the proportion of participants who reached 3% weight loss, with readings of 44%, 41% and 29% in the sequential, simultaneous and app-only groups, respectively. In addition, 31% of participants in the simultaneous group reached 5% weight loss compared with 21% of the sequential group and 15% of the app-only group, with the researchers noting that these were not statistically significant differences.

The researchers also found little difference between the sequential and simultaneous groups in days with tracked weight and among all three groups after 1 month in diet tracking. However, there was an association between weight change and the percentage of days tracking weight in the simultaneous (P = .02) and sequential (P = .01) groups. Diet tracking was linked to weight change in the app-only group (P = .003) and the sequential group once it was adopted (P = .02), but not in the simultaneous group.

“There were two surprising outcomes. The first was that our ‘app only’ control group performed better than we expected. This suggests that even a minimal approach can help adults with overweight or obesity achieve weight loss of 2 kg to 3 kg (5 lbs to 6 lbs), on average, over a 3-month period, and sustain that weight loss through 6 months,” Patel said. “The second surprise, was that it didn’t seem to matter if you delayed diet tracking vs. if you got started with tracking your diet right away.” – by Phil Neuffer